Wendy Erickson RN
Eau Claire WI
Lynn Hadaway, M.Ed., NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Office Phone 770-358-7861
You must know where the tip is prior to use.
To illustrate this, I placed a R side PICC that had no problems what so ever during placement, CXR was a little abnormal but a number of radiologists could not tell where the tip or catheter really were, even after we did a latteral view, it looked ALMOST as if it was in the SVC w/ tip in the CavoAtrial junction. IR Docs said for me to bring the patient down, they injected contrast only to find out it was all the way deep into the R thoracic vein, which in that patient was almost excatly paralel but about 1 cm "off" to right of the SVC.
From seeing the contrast flow, we could tell that the PICC was sitting very tightly in the thoracic vein, had it been used for TPN or Vanco, I don't want to think what kind of damage that would have created.
Untill you are 100% sure where the tip is, after insertion, you should not use it.